On Call

Oh the wonder of being on call. At my agency, NPs are on call Monday through Thursday 5P-8A, or Friday through Sunday from 5P Friday until 8A Monday. The latter is my job this weekend. It's grueling at times, because the phone rings day and night. There are stretches when it doesn't ring at all. Then suddenly there is a deluge of calls at the same time. Afternoons and evenings are usually busy. But I've had nights where the phone never stopped and I never slept.

What I've learned from this experience is that my first customer is the nurse at the end of the phone line. Yes, it's about the patient, but my relationship with the calling nurse makes all the difference. I had a call yesterday from a newly hired nurse, still in orientation. He was so afraid of saying the wrong thing, of not saying the right thing, and generally of offending me. He kept calling me "ma'am". I may not be "one of the gang", but I don't want to be seen as an ogre either. I finally told him, listen, these are the things I need to know up front on a call, and I don't bite. He sort of laughed at that, and I reminded him that I'm a nurse too, but with maybe another degree and more experience. He seemed to relax a bit. Hopefully as time goes by he will get comfortable, but right now I'm hearing someone overwhelmed with everything he has to learn.

I've been doing this for several years with the same agency and many of the nurses are like phone friends. When Maggie calls, I know her distinctive voice. I know also that I'm going to get a complete description of the situation in the home, and her experience will help me understand what steps to take. I can trust her, I've learned that. I've actually met Sabrina, and she's as vivacious as her voice sounds. She brings her positive attitude to everything she does, whether a class on documentation or attending a death. The whole team of weekend nursing staff, about 15 of them, are excellent, caring nurses who understand hospice and can communicate that on the phone.

So I've spent some time cultivating a relationship with each of them. They know when they call me we will discuss the problem, and see if together we can find a solution. In turn, I know that they will not hesitate to call me, as they do with others in my group, for fear of getting barked at. In the end, the patient reaps the benefit.